Search

Background: Treating acute ST segment elevated myocardial infarction (STEMI) patients by primary PCI (pPCI) has dramatically fallen globally in covid era as there is chances of potential threat of spreading COVID among the non-COVID patients. Thereby, thrombolysis of acute STEMI patient in grey zone till COVID RT PCR report to come, was the mode of treatment of acute myocardial infarction patient in our hospital. We have carried out this prospective observational study to see the outcomes of thrombolysis and subsequent intervention. Methods: STEMI patient who presented to our emergency department with chest pain and ECG and hs-Troponin-I evidenced acute STEMI, were enrolled in the study. Total 139 patients enrolled (Male:120, Female :54); average age for Male: 54 yrs., female was: 56yrs. All patients were admitted in the grey zone of CCU where thrombolysis was done. COVID-19 patients were excluded from intervention and managed conservatively. Covid Negative patients were kept transferred to CCU green zone. On average 2.1 days after Fibrinolysis, elective PCI carried out. Data analysis from 48 patients who underwent pharmacoinvasive therapy was done. Results: Among the study population, Covid-19 positive was in 11 (7.9%) patients and Covid-19 was negative in 128 (92.1%) patients. Primary PCI was performed in 7 (5.03%) patients. Rest of the patients were managed by Pharmacoinvasive therapy. Thrombolysis by Tenecteplase (TNK) was done in 89 (64%) patients, and by Streptokinase in 25 (17.9%) patients, 18 (12.9%) patients did not receive any thrombolysis due to late presentation. Chest pain to needle time was 7.2 ±12.7hrs., thrombolysis to balloon time was 117.5 ±314.8hrs. More than 50% stenosis resolution observed in 20 (41.6%) patients, chest pain resolution within one hour of thrombolysis observed in 21 (43.8%) patients. Ten (20.8%) patients developed. Door to needle time was 30 mins. Total, 88 stents were deployed in 83 territories. CABG was recommended for 7 (5.03%) patients. Stented territory was LAD 37 (45.7%) and RCA 32 (39.5%) and LCX 12 (14.8%). Conclusion: In the era of COVID-19, in this prospective cohort study, on acute STEMI patient management, we found that Pharmacoinvasive therapy, reduced patients’ symptoms and ST resolution occurred partially. Cardiovasc j 2023; 15(2): 136-143

Introduction: Alzheimer’s disease (AD) is a degenerative disease and dementia is a neurological condition which is significantly caused by AD. Sometimes it is found at early to middle age which is associated with cognitive and functional impairment. There is no significant curative treatment till now but only symptomatic treatment in available. Aim of this study is to describe evidence-based physiotherapy management for fall prevention associated with Alzheimer’s disease. Case Report: This is a case-based study which features an elderly man who has just fallen for the few times and has early Alzheimer’s disease (AD). In literature, exercise therapy is proven to be effective for fall management. Exercise was demonstrated by the physiotherapist and follow-up was done on a regular basis. The fall prevention exercise included core muscle strength training, cue gait training, fall prevention strategy, and task-based functional activity practice focused on Alzheimer’s symptoms. The patient was assessed with the Tinetti Patient Oriented Mobility Assessment (POMA) and Berg Balance Scale score (BBS). The initial score was 8/28 for POMA and 19/56 for BBS, and after 8 weeks it was recorded as 19/28 and 21/56. Oxford muscle grading system was used for measuring strength. Conclusion: Final outcomes suggested minor improvements in balance, strength of lower limbs, functional activities. This case study focuses on the importance of physical exercise to improve balance and prevent consequences of fall.

The development of effective anticancer drugs is essential for chemotherapy that specifically targets cancer tissues. We recently synthesized a multifunctional water-soluble anticancer polymer drug consisting of styrene-maleic acid copolymer (SMA) conjugated with glucosamine and boric acid (BA) (SGB complex). It demonstrated about 10 times higher tumor-selective accumulation compared with accumulation in normal tissues because of the enhanced permeability and retention effect, and it inhibited tumor growth via glycolysis inhibition, mitochondrial damage, and thermal neutron irradiation. Gaining insight into the anticancer effects of this SGB complex requires a determination of its structure. We therefore investigated the chemical structure of the SGB complex by means of nuclear magnetic resonance, infrared (IR) spectroscopy, and liquid chromatography-mass spectrometry. To establish the chemical structure of the SGB complex, we synthesized a simple model compound─maleic acid-glucosamine (MAG) conjugate─by using a maleic anhydride (MA) monomer unit instead of the SMA polymer. We obtained two MAG-BA complexes (MAGB) with molecular weights of 325 and 343 after the MAG reaction with BA. We confirmed, by using IR spectroscopy, that MAGB formed a stable complex via an amide bond between MA and glucosamine and that BA bound to glucosamine via a diol bond. As a result of this chemical design, identified via analysis of MAGB, the SGB complex can release BA and demonstrate toxicity to cancer cells through inhibition of lactate secretion in mild hypoxia that mimics the tumor microenvironment. For clinical application of the SGB complex, we confirmed that this complex is stable in the presence of serum. These findings confirm that our design of the SGB complex has various advantages in targeting solid cancers and exerting therapeutic effects when combined with neutron irradiation.

Background: Tele rehabilitation can deliver rehabilitation services with the use of technology to increase patient options, deliver services more efficiently and overcome geographical barriers to healthcare access. Despite its popularity, there is conflicting evidence for its effectiveness. Therefore, the aim of this systematic review was to update the current evidence base on the effectiveness of tele rehabilitation for stroke. Objective: We aimed to provide an updated systematic review on the efficacy of tele-rehabilitation interventions for stroke survivors. Method: PubMed, Google scholar, Physiotherapy Evidence Database (PEDro), Cochrane Library were searched, and the studies which were RCT, had tele-rehabilitation interventions, Published in English language, had moderate to high methodological quality (PEDro scoring 5 or more than 5). Results: Out of 218 studies, 04 randomised controlled trials met the eligibility criteria and quality assessment and were selected for the present systematic review. A diverse range of interventions were delivered through a variety of tele rehabilitation systems. Summarized findings from the heterogeneous evidence base indicate that tele rehabilitation may have a positive impact on a range of primary and secondary outcomes. Conclusion: Tele rehabilitation, as an alternate form of rehabilitation for people with stroke, shows potential. This updated systematic review provides evidence to suggest that tele-rehabilitation interventions have either better or equal salutary effects. However, due to methodological and practical concerns, an unequivocal recommendation cannot be made. Findings from this review may inform future policies and practices regarding the use of tele rehabilitation for stroke patients.

Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity in our Bangladeshi patient population. Percutaneous coronary intervention (PCI) or Coronary artery bypass grafting (CABG) are the gold standard of revascularization to treat these group of patients. Both treatment modalities may contribute to both short term and long-term excellent benefit with the relief of symptoms and improves quality of life. Beside the availability of modern techniques along with 3rd generation Drug eluting stents (DES) for PCI and uses of arterial conduit in bypass surgery, in long-term follow-up, many of the patient needs repeat revascularization. In Bangladesh, many of the centers are doing state of the art treatment with the available of most of interventional aids in treating complex PCI as well as primary PCI. Similarly, CABG with the advent and available expertise, minimal invasive bypass surgery or beating heart surgery, facilitate CABG more convenient for patient and surgeons as well. Exact data on stent occlusion or graft failure that may leads to repeat revascularization is not well understood in our circumstances. We need to form a common consensus, if needed, to form a national registry or database to follow up PCI or CABG patients who develop subsequent revascularization failure and address the reason behind. Thus, to reduce the needs of repeat revascularization and improve long term quality of life. Cardiovasc j 2022; 15(1): 81-85

Background: Radiofrequency catheter ablation is a curative modality of treatment for paroxysmal supraventricular tachycardia. The aim of our study was to evaluate our experience of electrophysiology procedures and radiofrequency ablation in atrioventricular reciprocating tachycardia (AVRT). Methods: All patients undergoing cardiac electrophysiology and radiofrequency ablation procedures during the period from July, 2019 to July, 2021 at Department of Cardiology, Evercare Hospital, Dhaka were included in this study. The study analyzed 141 patients of among them 75(53.2%) patients were male and 66(46.8%) were female. Results: Patients who came with AVRT, 91 (65%) had concealed and 50 (35%) had manifested. The overall short term success rate was 99 %. There was no difference in the success rates between the younger and older patients. Complication rate is lower side of the spectrum, which is 1.4% (four patients). Conclusion: Radiofrequency ablation is a safe and successful treatment modality for patients with atrioventricular reciprocating tachycardia in this real - world study. Cardiovasc j 2022; 15(1): 20-25

Alcohol septal ablation (ASA) has shown to be a safe and effective procedure for treatment of symptomatic hypertrophic obstructive cardiomyopathy (HOCM) for more than 20 years with results similar to those of surgical myectomy. The first septal branch of the left anterior descending artery (LAD) is located and 96% alcohol is instilled to induce an artificial myocardial infarction and necrosis at the base of the hypertrophied septum. Now we present our first experience of a patient with HOCM with a very high left ventricular outflow tract gradient who had successful alcohol septal ablation. Cardiovasc j 2022; 15(1): 95-99

Introduction: Benign enlargement of prostate (BEP) is one of the common problem in elderly male. Most of the patients present with lower urinary tract symptoms (LUTS) which consist of voiding symptoms and storage symptoms. Transurethral resection of prostate (TURP) is the gold standard treatment option for BEP. TURP improves both obstructive and storage symptoms in majority of cases. But sometimes storage symptoms persist after TURP. This study was done to predict the factors for persistence of storage symptoms after TURP by evaluating clinical and urodynamic variables. Objective: To predict the factors for persistence of storage symptoms after transurethral resection of prostate (TURP) by evaluating clinical and urodynamic variables. Materials and Method: This was a prospective analytic study done in the department of Urology, Bangabandhu Sheikh Mujib medical university (BSMMU), Shabagh, Dhaka. In this study, total 60 patients of BEP with the indication of TURP were enrolled. Preoperative data includes Age of the patient, International prostate symptoms score(IPSS), IPSS storage sub score, Qmax, QoL scores, Maximum cystometric capacity(MCC), Post void residue(PVR), PdetQmax, Bladder contractility index (BCI) and postoperative data includes post-operative IPSS storage sub score, Qmax were recorded and analyzed. Result: Among preoperative variables, Age (>65y) and IPSS storage sub score has highest predictive value. Bladder contractility index (BCI) and MCC have significant predictive value. Qmax and PVR have also predictive value. Conclusion: This study result shows elderly patient of higher age group, preoperative high IPSS storage sub score, smaller MCC & high BCI have chance of persistence of storage symptoms. Bangladesh J. Urol. 2021; 24(2): 135-140

Supplementary Figure S2 shows increased survival of B16 melanoma treated with combination of polymeric drug (P-THP) and various NO donors.

Enhanced permeability and retention (EPR) effect–based nanomedicine is a promising strategy for successful anticancer therapy. The EPR effect is based on tumor blood flow. Because advanced large tumors, as frequently seen in clinical settings, are heterogeneous, with regions of defective vasculature and blood flow, achieving the desired tumor drug delivery is difficult. Here, we utilized the EPR effect to increase drug delivery. To augment the EPR effect for improved therapeutic effects of nanomedicine, we exploited vascular mediators—the nitric oxide (NO) generators nitroglycerin (NG), hydroxyurea, and l-arginine. These compounds generate NO in tumors with relatively high selectivity. Using different nanosized drugs in our protocol significantly increased (1.5–2 times) delivery of nanomedicines to different solid tumor models, along with markedly improving (2–3-fold) the antitumor effects of these drugs. Also, in 7,12-dimethylbenz[a]anthracene–induced advanced end-stage breast cancer, often seen in clinical settings, 2 mg/kg polymer-conjugated pirarubicin (P-THP) with NG (0.2 mg/mouse) showed better effects than did 5 mg/kg P-THP, and 5 mg/kg P-THP used with NG resulted in cures or stable tumors (no tumor growth) for up to 120 days. Moreover, in a murine autochthonous azoxymethane/dextran sulfate sodium-induced colon cancer model, NO donors markedly improved the therapeutic effects of P-THP even after just one injection, results that were comparable with those achieved with three weekly P-THP treatments. These findings strongly suggest the potential usefulness of NO donors as EPR effect enhancers to improve the therapeutic efficacy of nanomedicines.

Bifurcation lesion whether it is left main (LM) stem disease with left main to left anterior descending artery (LM-LAD) or left main to left circumflex (LM-LCX), LAD-Diagonal or LCX-Obtuse marginal or right coronary artery- posterior descending artery (RCA-PDA); are not uncommon lesion type that needs to be revascularized either by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) to establish the coronary flow and relieved patient anginal symptoms. Even though, many of the literature maintained non-inferiority of bifurcation lesion PCI over CABG and is Class IIb indication for PCI by coronary stent. In literature, bifurcation lesions commonly encountered in PCI and are regarded as most technically challenging lesions to treat, in up to 20% of PCI cases. With the advent of interventional procedures and the availability of cardiac catheterization laboratory facilities, skilled interventionist, many of the Bangladeshi patients are being treated for coronary artery diseases (CAD). With the advent of drug eluting stents, availability of IVUS (Intravascular Ultrasound), FFR (Fractional Flow Reserve) and individual expertise, treating bifurcation lesion may not be difficult task. Interventionist must be expert enough in doing PCI, before to proceed for bifurcation lesion PCI. We need to work together to develop common consensus in developing updated skill in treating bifurcation lesion which will prove bifurcation PCI in our population. Cardiovasc j 2022; 14(2): 168-175

Background: Primary percutaneous coronary intervention (pPCI) is the preferred and established mode of treatment in ST elevated myocardial infarction (STEMI). Exact data on procedural outcome in patient undergoing primary PCI in our population is not well documented. We have carried out this study to see the prognosis, in-hospital, and 12-month survival outcome of our patients. Methods: Patients were enrolled in the observational non-randomized prospective cohort between November 2017-Mar 2020, who were presented into our emergency department with acute onset of severe chest pain or angina with ECG evidenced acute ST elevated myocardial infarction. Total 182 patient (Female 14; Male 168) were enrolled in this study. Results: Out of 182 patients, anterior MI were 47.8% (n=87) and inferior MI 50.5% (n=92) and lateral MI 1.6% (n=3). Presentation to ER from the onset of chest pain for female :123 min vs. male: 112 min and average door-to-balloon time were for female: 53 min vs. male: 50 min. Hospital admission of STEMI were more after 5 pm to next morning 9 am. Death were more in anterior STEMI than inferior STEMI. At presentation 10.4% (n=19) patents were in cardiogenic shock with STEMI, 42.1%(n=8) patients with anterior MI, 57.9% (n=11) in inferior MI group. Total, 15 (8.2%) patients died; 93.3% (n=14) within one week of primary PCI due to shock and poor LV function and subsequent development of LVF with arrhythmia and 6.7% (n=1) patient died 6 months after pPCI due to other cause. Conclusion: In this prospective observational cohort study, we found that PCI is a good and effective treatment modality in treating STEMI patient with better myocardial salvage and avoidance of life-threatening complications. Our procedural success rate is 91.8% and patients are doing well with regular follow up at our OPD 12-months after primary PCI. Cardiovasc j 2022; 14(2): 111-120

Coronary artery disease (CAD) is one of the leading causes of death in our patient population. In the era of cardiovascular intervention, Percutaneous coronary intervention (PCI) is one of the most important modalities in treating these group of patients. Several CAD risks factors and co-morbid conditions are key responsible factor of procedural success. High bleeding risk (HBR) patients undergoing PCI is not an uncommon phenomenon. Incidences and prevalence of HBR patients with CAD and their management by PCI is not well addressed in our literature. PCI in HBR patients carries potential risk of intracranial hemorrhage (ICH) and lifethreatening bleeding. Therefore, careful pre-PCI assessment of possible risk or threats of post-PCI complications in patients with HBR are deem necessitate to understand. We recommend forming multicenter common consensus and to form a guideline in treating HBR patient by PCI. Thus, to reduce post procedural complication and subsequent improvement of mortality and morbidity in HBR patients undergoing PCI in both ST segment elevated myocardial infarction (STEMI) and as well as non-STEMI. Bangladesh Heart Journal 2021; 36(2): 133-138

Bentonite has been modified using H2SO4 at various concentrations to alter Si/Al ratio that is responsible for catalytic pyrolysis of single-use waste polyethylene (SUWP). The XRF analysis confirmed a gradual decrease of Al2O3 content with an increasing concentration of H2SO4. The highest liquid hydrocarbon yield (87.48%) was obtained at Si/Al ratio of 34.24. To further activate acid-modified bentonite, bimetals (Cu/Ni, Fe/Ni, and Co/Ni) impregnation was conducted. The catalytic performance was compared with monometals (Ru, Co, Ni, Cu, and Fe) impregnated bentonite counterparts. The Co, Ni, or Cu impregnated bentonite catalysts (with 86, 83, and 86% yield) outperformed Fe and Ru impregnated bentonite catalysts (with 68% and 79% yield). However, bimetallic (Cu/Ni, Fe/Ni and Co/Ni) catalysts enhanced severe cracking leading to the formation of more gaseous hydrocarbons and thus less amount of liquid (70–80%) is obtained. Incorporation of iron into bentonite or Ni/bentonite increased the amount of 2-Octene, 3,7-dimethyl-, (Z)- compared to acid-treated bentonite and Ni/ bentonite catalysts. Moreover, Fe/Ni/bentonite has also increased the amount of 2-Octene, 2,6-dimethyl- compounds. The BET analysis shows that both surface area and pore diameter increased due to acid treatment resulting in an increase in the percent yield of liquid compared to raw bentonite. The FTIR and GC-MS analysis confirmed that the liquid hydrocarbon consists of linear and branched alkanes and alkenes with some cyclic hydrocarbons. The NMR analysis showed the liquid hydrocarbon is free from the aromatic compounds and polycyclic aromatic hydrocarbons (PAH).

Background: Primary percutaneous coronary intervention (pPCI) is the preferred and established mode of treatment in ST elevated myocardial infarction (STEMI). Exact data on procedural outcome in patient undergoing primary PCI in our population is not well documented. Therefore, we have carried out this study to see the prognosis, in-hospital, and 12-month survival outcome of our patients. Methods: Patients were enrolled in the observational non-randomized prospective cohort between November 2017-Mar 2020, who were presented into our emergency department with acute onset of severe chest pain or angina with ECG evidenced acute ST elevated myocardial infarction. Total 182 patient (F 14; Male 168) were enrolled in this study. Results: Out of 182 patients, female :14 (7.7%) vs. Male: 168 (92.3%). Among, these patient females were more obese (BMI: Female 27.1 ± 2.1 vs. male 25.8 ± 4.1) and developed CAD in advance age (Female 59.1 ± 13.5 vs. Male 53.7 ± 10.5). Anterior MI were 47.8% (n=87) and Inferior MI 50.5% (n=92) and Lateral MI 1.6% (n=3). At presentation 10.4% (n=19) patents were in cardiogenic shock with STEMI, 42.1%(n=8) patients with Ant MI, 57.9%(n=11) in Inf MI group. Total, 15 (8.2%) patients died; 93.3%(n=14) within 1 week of pPCI due shock and poor LV function and subsequent development of LVF with arrhythmia and 6.7%(n=1) patient died 6 months after pPCI due to other cause. Death was more in Ant Wall STEMI than Inferior wall STEMI, though Cardiogenic shock at presentation were more in Inf MI STEMI than Ant wall STEMI. Conclusion: We may conclude from our observational study on STEMI PCI that the territory wise involvement of myocardium, baseline serum Troponin-I level, infarcted vessel, time to presentation, duration of anginal chest pain and door to balloon time may be the key determinant of better in hospital outcome. Cardiovasc. j. 2021; 13(2): 154-163

A patent foramen ovale (PFO) is highly prevalent in patients with strokes of unknown cause or cryptogenic strokes (CSs). It has been remained an unsolved question as to whether a PFO should be closed or not to prevent recurrent strokes in patients diagnosed with cryptogenic stroke (CS). A paradoxical embolism through a PFO is pointed as a leading cause of CS, especially in younger patients with low risk factors for stroke. It also remains an unsolved matter on type of anti-coagulation therapy, which would be better for patients with CS and a PFO. In addition, surgical and transcutaneous closure of a PFO has been proposed for the secondary prevention of stroke in patients with CS with PFO. Several randomized controlled trials have been conducted in recent years to test whether a PFO closure gives a significant benefit in the management of CS. Many investigators believed that a PFO was an incidental finding in patients with CS. However, meta-analyses and more recent specific trials have eliminated several confounding factors and possible biases and have also emphasized the use of a shunt closure over medical therapy in patients with CS. Therefore, these latest studies can possibly change the treatment paradigm in the near future. We are reporting a case of cryptogenic ischaemic stroke in middle cerebral artery territory due to paradoxical embolism through a PFO which was successfully closed with a device solely by a Bangladeshi Consultant & his team first time in Bangladesh. Cardiovasc. j. 2021; 13(2): 227-234

Ischemia of non-occlusive coronary artery disease (INOCA) not an uncommon phenomenon, exist in our patient population which did not address well. Many of the stable angina and or unstable angina patient, whose coronary angiogram revealed significant coronary stenosis (>70%) are being treated by PCI with drug eluting stent. On the contrary, quite a significant proportion of patient, who are found to have non-significant coronary lesion (

Background: It is well known that coronary artery bypass graft (CABG) is considered as gold standard treatment of left main (LM) stem disease. Over the years PCI of left main (LM) stem disease, proved its non-inferiority to CABG in treating LM stem disease Objectives: Exact data of LM stem PCI and its procedural success, in-hospital, and post-procedural one-year survival outcome in-terms of repeat hospitalization due to re-infarction, LVF and death, in our population not known clearly. Therefore, we have carried out this prospective observational cohort to see the overall outcomes of LM Stem, PCI in our population Methods and materials: Patients who underwent elective CAG and found LM stem disease and planned for PCI, were enrolled in this non-randomized observational study between November 2013 to September 2019. Total 146 patient (F 29; Male 117) were enrolled in this study. Results: Out of 146 patients, female :19.8% (n=29) vs Male: 80.1% (n=117). Among, these patient females were more obese (BMI: Female 29.8 ± 3.6 vs male 26.8 ± 3.8). Male patients were older than female; Male 59 yrs. vs female 56 yrs. Among the CAD risk factors Hypertension (HTN) 67.8% (n=99), dyslipidemia 56.2% (n=82), Diabetes Mellitus (DM) 51.4% (n=75), smoking 31.5% (n=46), Family history of CAD (FH) 21.2% (n=31). In this study, 19.2%(n=28) patient had CABG in the past. Common Stented territories were ostial LM 6.8%(n=10), shaft of LM 28.8% (n=42), distal LMLAD 47.3% (n=69), distal LM-LCX 15.1% (n=22) and distal LM-RI 2.7% (n=4). Common DES were Everolimus 69.9% (n=102), Sirolimus 12.3% (n=18), Zotarolimus 9.6%(n=14), BMS 4.8% (n=7), Sirolimus with Epithelial Progenitor Cell 3.4% (n=5), and Biolimus 2.1% (n=3). In terms of post procedural dual antiplatelet therapy (DAPT), patients receiving Clopidogrel were 57.5% (n=85), Ticagrelor 28.8% (n=42), and Prasugrel 13.7% (n=20). Total 12 patient died due to acute, sub-acute stent thrombosis or reinfarction with or without arrhythmia. Relook CAG done was only in 14.4% (n=21) patients, Stent patency 80.9% (n=17), significant ISR, later went to CABG 14.3%(n=3) and mild ISR 4.7% (n=1). IVUS guided PCI were done only in 10.9% (n=16) patients. Major adverse cardiac events in terms of periprocedural MI, repeat hospitalization or death were not common in this study. Conclusion: PCI of LM stem disease is one of the important treatment modalities over CABG in our patient population. Very few patients developed re-stenosis, that needs repeat revascularization either by PCI or CABG. Thus, we may conclude, PCI of LM stem disease might be an alternative to CABG and needs comparative multicenter study to justify its superiority outcome in our patient population. Bangladesh Heart Journal 2020; 35(2) : 78-86

Background: Nephron-sparing surgery is an accepted treatment modality for renal cell carcinoma (RCC) in certain situations. Objectives: The aim of this study was to compare perioperative outcomes after laparoscopic and open partial nephrectomy for patients with a solitary renal tumors of 7cm or less in different institutes in Dhaka. Methodology: Between June 2013 and October 2020, 23 patients had undergone LPN and 24 patients had undergone OPN for the treatment of solitary renal tumors of 7cm or less in different institutes in Dhaka. Large renal mass (>7cm), multiple tumor and patients with complex renal anatomy were excluded from this study. Patients having previous abdominal surgery were excluded from LPN and all LPN were performed transperitoneally. Results: Although the mean operative time was longer in the LPN than in the OPN group (134.4±35.36 (45-180) minutes versus 110.56±35.36 (60-165) minutes; P

Controlling the particle structure of tumor-targeting nanomedicines in vivo remains challenging but must be achieved to control their in vivo fate and functions. Molecular bottlebrushes (MBs), where brush side chains are densely grafted from a main chain, have recently received attention as building blocks of polymer-based prodrugs because their rigid structure would be expected to demonstrate high structural stability in vivo. Here, we synthesized a poly(methacryloyloxyethyl phosphorylcholine) (pMPC)-grafted molecular bottlebrush (PCMB) conjugated with a cancer drug, doxorubicin (DOX), via an acid-cleavable hydrazone bond. A pMPC-based linear polymer (LP) conjugated with DOX was also prepared for comparison. We confirmed the lack of structural transition in the PCMB between before and after conjugation with DOX using small-angle light and X-ray scattering techniques, whereas the structure of LP was significantly influenced by DOX conjugation and transformed from a random-coil structure to a large agglomerate via hydrophobic interactions among DOXs. Although PCMB-DOX and LP-DOX showed comparable tissue permeability, pharmacokinetics, and ability to accumulate in tumor tissues, the antitumor efficacy of PCMB-DOX was better than that of LP-DOX. This was presumably due to the formation of LP-DOX agglomerates. The diffusion of cleaved DOX would be restricted in the hydrophobic core of the agglomerate, resulting in the DOX release at the tumor site being compromised. In contrast to LP-DOX, DOX release from PCMB-DOX was not compromised after accumulation in tumor tissues because it did not form such an agglomerate, resulting in the strong antitumor effect. We have demonstrated the potential of MBs as building blocks of drug carriers and believe that these findings can contribute to the design of polymer-based nanomedicines.

Covid-19 pandemic has affected millions of patients, killed more than half a million, and poses major health threat globally. There is high demand for clinical resources and bed space for COVID- 19 patients. Admission of patient of any cardiac emergency in a common block of hospital, country like Bangladesh, may exposes the risk of infection among non-COVID patient. Patient with COVID- 19 and pre-existing cardiovascular diseases (CVD) have increased risk of further aggravation and death. COVID-19 infection is usually associated with multiple direct and indirect cardiovascular complications, such as acute myocardial injury, myocarditis, arrhythmias, heart failure and venous thromboembolism. Health care worker may pose themselves in vulnerability as they become host or vectors of virus transmission. Defeating COVID-19 and managing acute cardiovascular emergencies in COVID-19 era exposes non-COVID-19 patient, may need dramatic reshaping of care delivery, novel approaches to patient’s management and large-scale reallocation of resources. Cardiovasc. j. 2020; 13(1): 75-80

Background of the study: Urolithiasis has an incidence in the world of about 5% and the probability of a recurrence within 5–7 years is 50% (Parmar, 2004). Exact data about its prevalence is not known in Bangladesh but it is quite common as seen in outpatient department. It is more common in northern part of the country, male suffer more than female (M:F: 3:1) (Salam, 2002). Symptomatic ureteral calculi represent the most common condition encountered by an urologist in an emergency setting (Pak, 1998). Intervention is recommended for individuals with larger stones, especially greater than 5 mm (Kupeli et al., 1998). The treatment of this pathology was revolutionized with the introduction, in the late 1980s, of extracorporeal shock wave lithotripsy (ESWL), a non-invasive technology that has become one of the primary treatments for urinary stones. Its success rates vary depending on stone size and location and by the type of lithotripter employed. Medical expulsion therapy (MET) can play a key role in support of ESWL: specifically, expulsion is done by diuretics, calcium antagonists, anti-edema agents, and alpha-blockers. A few studies have reported their effectiveness (Borghi et al., 1994, Cervenakov et al., 2002, Porpiglia et al., 2002,Dellabella et al., 2003). Objective: This study is carried out to find out the role of Tamsulos in stone clearance in patientswith upper ureteral stone after extracorporeal shock wave lithotripsy (ESWL). Methods & Material: This randomized control clinical trialwas performed in Department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBangla Nagar, Dhaka during the period from July 2015 to June 2017. A total of 70 cases with upper ureteric stone were included during the study period. Patients were selected randomly in every alternate sequence, odd numbers for experimental group, Tamsulosin+ ESWL, group A & even numbers for control group, only ESWL, group B. Stone clearance rate, number of ESWL session and stone expulsion time were evaluated. Results: In this study showed complete stone clearance one month after ESWL in Group A was 16(89%) and Group B was 16(84.21%) for stone size 6 to 10 mm. Comparison of clearance rate between two groups in stone size 6 to 10 mm was not statistically significant (p value >.05). Complete stone clearance one month after ESWL in Group A was 13(76%) and Group B was 07(43.75%) for stone size 11 to 15 mm. Comparison of clearance rate between two groups in stone size 11 to 15 mm was statistically significant (p value

Objective: To determine the correlation of international prostate symptom score with Intravesical protrusion of prostate. Methods: This prospective clinical study was performed on 60 elderly patients presented with LUTS suggestive of Benign Enlargement of Prostate. Their evaluation included DRE, IPSS, Uroflowmetry (Qmax), serum PSA measurements and trans abdominal ultrasound scan. Statistical analysis was performed by SPSS version 13 using Chi square test and scatter plots together with Spearman’s correlation coefficients were used to assess the relationship between IPP and IPSS. Results: Mean age of the patients was 66.7+9.85 years, IPSS 23.6+6.53, mean prostatic volume was 60.23+38.16 mL, Qmax 7.98+3.87, PVR was 163.18+141.73 mL. Fifty percent of patients had severe degree (>10mm) of intravesical protrusion of the prostate, 30% had moderate and 20% had mild IPP. There was significant positive correlation between IPSS and IPP (r=0.698, P < 0.001). Conclusion: From this prospective clinical study it is revealed that IPP had strong correlation with IPSS. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.151-154

Objective: To evaluate the role of flexible cystoscopy and ultrasound together in thedetection of recurrent superficial bladder tumors Method: This hospital based prospective comparative study was carried out in theDepartment of Urology, National Institute of Kidney Diseases and Urology, Sher-E-Banglanagar, Dhaka from January 2013 to June 2014. A total of 85 patients of post transurethralresection (TUR) and post chemotherapy state for superficial bladder tumors were includedin this study. Transabdominal ultrasonography of the bladder was performed for all casesby a consultant radiologist. Flexible cystoscopy was performed by a trained urologist forall. Finally conventional rigid cystoscopy with or without biopsy was performed at thesame setting to confirmed the findings. Result:The mean age was found 62.9±9.7 years with range from 41 to 80 years. Majority(82.4%) patients were male and 15(17.6%) patients were female. Male female ratio was4.7:1. It was observed that majority (54.1%) patients was found pT1 stage and 39(45.9%)was pTa stage. It was observed that more than two third (67.1%) patients had grade-Iand 28(32.9%) had grade-II.Sensitivity, specificity, accuracy, positive and negativepredictive values of combine USG and flexible cystoscopy for identification of recurrenttumors were 92.7%, 33.3%, 90.6%, 97.4% and 14.3%. Conclusion: Ultrasonography and flexible cytoscopy together can detect recurrentsuperficial bladder tumors as accurate as conventional rigid cytoscopy. Bangladesh Journal of Urology, Vol. 22, No. 1, January 2019 p.41-46

Two sensitivity analyses were performed in an Aspen simulation of fluidized bed gasification for five different gasifying agents such as steam, hydrogen peroxide (H2O2), pure oxygen (O2), carbon dioxide (CO2), and air. In the first sensitivity analysis, the modified equivalence ratio (MER) was varied (0.22-0.36). For the varied modified equivalence ratio (MER), %hydrogen, H2/CO molar ratio, and hydrogen yield were the highest in steam-gasification, but %carbon monoxide, %methane, CO yield, and the lower heating values (LHV) were the highest in CO2-gasification. In the second sensitivity analysis, the freeboard temperature was varied (500-900 °C). With increasing freeboard temperature, %hydrogen and %carbon monoxide increased while %carbon dioxide and %methane decreased for all the gasifying agents. Also, with increasing freeboard temperature, the LHV decreased and the hydrogen yield, CO yield, and the gas production rate increased for all the gasifying agents, but the H2/CO molar ratio increased only in oxygen, air, and CO2-gasification.

Objective: To find out the optimum evaluation tools for male infertility. Methods: Hinari database were searched for articles related to male infertility for review to find out how a male infertile patient can be evaluated optimally.EUA guidelines on Male Infertility and AUA best practice statement on Optimal Evaluation of the Infertile Male updated on 2010 were also considered for review. Results: Initially thirty five articles were obtained and finally twenty eight articles were considered for review. Some cross references were considered to be cited in the reference section. We have mentioned in this review the evaluation tools those are necessary for male factor infertility at the optimum. Conclusion : As male infertility problem are increasing so optimum evaluation should be carried out to diagnose every possible underlying cause. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.43-48

Objectives: To find out any changes in renal function in donor following kidney donation. Materials and Methods: A Hospital based prospective study was conducted in the Department of Urology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from April 2011 to September 2012, Investigations included specific gravity and urinary microalbumin, ultrasonogram of kidneys, serum creatinine, estimated glomerular filtration rate. According to inclusion and exclusion criteria a total of 37 donors were enrolled in this study. Subsequent follow up were taken at the end of three months, six months and nine months. Data were evaluated by Paired t-test, Significance was defined p value0.05) was found between baseline and the subsequent follow-up. Conclusion: Renal function of the remaining kidney in living donors does not significantly change after donor nephrectomy. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.18-22

Objective: To determine outcome of OMG urethroplasty by different surgical technique comparing ASOPA, BARBAGLI and KULKARNI TECHNIQUE in the management of anterior urethral stricture. Materials and Methods: A total of 62 patients with an average age of 42 yr(21-55) underwent OMG urethroplasty between 2008 to 2015 for anterior urethral stricture of different etiology. 2 patient lost durig follow up patient with lichen sclerosus and failed hypospadias were not included. OMG was always harvested from cheek using 2 team approach graft were placed using surgical technique of ASOPA, BARBAGLI and KULKARNI technique in 21,27 and 12 patients respectively clinical outcome was considered success or failure at the time any post operative procedure needed mean follow up was 45 month (6-95) Results: Out of 60 cases 51(85%) considered success and 9(15%) were considered failure. success rate were 85.7%,85%,and 83.5% in ASOPA, BARBAGLI and KULKARNI Technique and failure rate were 14.3%,15% and 16.7% respectively. Failure involve in the anastomotic site (2 in distal and 3 in proximal) were managed by OIU and involving whole length in 3 patient managed with staged urethropllasty. Conclusion: In our series, success rate of ASOPA, BARBAGLI and KULKARNI technique has no statistically significant variation. more over stricture recurrence was uniformly distributed in all group. so the outcome is not significantly affected by different technique used in OMG urethroplasty for anterior urethral stricture. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.23-27

Objective: To determine the short-term outcome of dorsolateral onlay urethroplasty in the treatment of long segment anterior urethral stricture. Materials and Methods: A prospective study from May 2011 to September 2012 is carried out in department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBanglanagar, Dhaka. Thirty one patients with long anterior urethral stricture were treated by a dorsolateral onlay buccal mucosa graft. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry

Advancement in imaging techniques has now made it possible for small renal tumors to be detected incidentally. This has led to the use of minimally invasive techniques for treatment of these cases. A 40 year-old woman was diagnosed to have a small renal mass after routine abdominal ultrasonography for epigastric discomfort. Computed tomography scan was used to characterize the mass, and an elective partial nephrectomy was successfully carried out. The procedure is safe, less morbid, and has good oncological outcome. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.49-52

Objective: To determine the outcome and complications of CAPD catheter implanted by open surgical technique for peritoneal dialysis. Methods: In this prospective study peritoneal dialysis catheter (PDC) for continuous ambulatory peritoneal dialysis was inserted into the abdominal cavity using an open surgical approach. We described our experience of open surgical minimal invasive technique of CAPD catheterization from July 2012 to June 2015. Total 40 catheters were inserted successfully. Patients were followed up for a variable period of 3-36 months. Results: In this study common indications of CAPD catheter insertion were CKD-5 due to diabetic nephropathy, chronic glomerulonephritis, and hypertensive nephrosclerosis. Common catheter related complications were peritonitis, hypokalaemia, exit site infection, catheter malfunction. Late peritonitis remains the major drawback of PD treatment, with the need of temporary or permanent changeover to the HD treatment in 10% of the patients. Conclusion: Enrichment of the physician’s interest and experience, along with a multidisciplinary approach to outline the optimal strategy of PD-catheter insertion and management of complications may improve technique and patients’ survival and decrease the morbidity. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.62-67

Objective: To evaluate the association of detrusor muscular activity with outcome of TURP in patients with severity of bladder outflow obstruction. Methods: This is a hospital based cross sectional study conducted in the Department of Urology of Dhaka Medical College Hospital, Dhaka.Elderly male patients having lower urinary tract symptoms (IPSS=20-35) with no retention (non-catheterized patient), who attended in Dhaka Medical College Hospital, were included in the study. A total of 73 patients meeting the enrollment criteria were included in the study. They were evaluated by history, physical examination including DRE and necessary investigations to identify the potential candidates for TURP. Then the potential participants were counseled for Urodynamic study. All patients underwent TURP by expert surgeon. Three months after TURP, repeat Urodynamic study was done and the results were compared to see the outcome. Afterward the data were plotted for the clarification of detrusor contractility at three levels: normal detrusor contractility (voiding pressure 40-60cm of water), detrusor over activity (voiding pressure >60cm of water) and detrusor under activity (voiding pressure 40); equivocal(BOOI=20-40);Unobstructed(BOOId” 20) are taken into consideration. The test statistic used to analyze the data was descriptive statistics and ANOVA test. The level of significance was set at 0.05 and P

Objective: To evaluate the effectiveness of single dose 5 % povidone iodine renal pelvic instillation sclerotherapy for the treatment for chyluria. Methods: In a prospective study from January 2009 and till June 2013, 47 patients presenting with milky urine (chyluria and hematochyluria) were included. Patients with other co-morbid illness like diabetes, urinary infection, renal stone disease, chronic pyelonehritis were excluded from the study. Apart from ether test, the presence of lymphocytes in urine and urine triglycerides levels were also done to confirm chyluria. Under local anesthesia, cystoscopic evaluation revealed right-sided efflux in 11 (23.4%), left-sided in 36 (76.6%), and no bilateral involvement was detected. 5F open-ended ureteric catheter was introduced in the ureteric orifice of affected side. Freshly prepared 10 ml of 5 % povidone iodine solution was instilled over a minute with the patient in Trendelenburg position. Results: Total of 47 patients were enrolled (26 males and 21 females; mean age 41 years, SD 8.4, range 29–71) with a mean follow-up of 12 months. Immediate clearance was seen in all patients and recurrence in 9 (19.15 %). Overall success rate 80.85%. Mean diseasefree duration was 12 months. Three patients had moderate to severe flank pain. Conclusion: Single dose 5 % povidone iodine sclerotherapy is a effective treatment for chyluria. As the patients discharged on the next day after procedure, it can be offered as a day care basis, so continuous ureteral and urethral catheterizations can be avoided. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.74-78

Objective : To observe the improvement of the symptoms of perineal heaviness and frequency after treatment with Magnetic Infra Red Laser therapy in patients of chronic pelvic pain syndrome /Chronic Prostatitis Methods : This study was an observational study done on 30 male patients with age range varied from 30 to 60 years .The study was conducted from 2009 to 2011 in a private medical center at Dhaka city . The MIL-therapy in use has a wave length of 904 nm and a frequency of 3000 Hz. The Laser beam reaches the prostate with a special optical probe. In this study the patient is examined per rectally after doing digital rectal examination with use of gloves and gel. At the beginning we used a “Laser Super Sonic” machine with endorectal optical probe according to Strada. The treatment schedule was one treatment every two days (treatment’s time of 5/10 minutes, wave length 1000 KHz) for a total of 10 applications. After 10 applications patients were asked for follow up and data were collected and analysed. Results : Out of 30 patients of chronic pelvic pain syndrome aged between 30-60 yrs were under treatment with MIL therapy. Among them only 22 patients were with complains of perineal heaviness, 20 patients were cured and 22 patients were with complains of frequency, 20 were cured and 02 were improved after laser treatment . Among 30 cases 23 patients found normal sized prostate and 07 found enlarged prostate on digital rectal examination and on USG findings, 21 were found normal sized , 09 found enlarged sized prostate and 07 patients had increased PVR . Conclusion : Treatment with Magnetic infra red laser therapy (MIL-therapy) gives useful effect on chronic pelvic pain syndrome (CPPS). The following short article gives a very good summary of the benefits of laser therapy and totally cured of symptoms . CPPS , a painful type of Chronic Prostatitis frequently troubles man for years. Among many sign and symptoms of CPPS , like perineal heaviness and frequency were observed and found very good effect after laser therapy. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.79-82

Objective: To find out the appropriate strategies to increase the donor pool for kidney transplantation. Methodology: The PubMed literature database was searched from 2015 to 20 years backward. Strategies to increase and improve live donor KT were suggested. In order to formulate some suggestions to reach that target, related experience and strategies published in journals of last 20 years both from developed and developing countries, were reviewed. Results: Strategies to increase and improve live donor KT were suggested .Only Live donor KT can never fulfil the demand of KT. The most important step to boost up KT program is to start deceased Donor Organ Transplantation and by formulating a law and establishing infrastructure. Development of National Kidney Transplant Registry and coordination of KT at National level is also very important. Those patients who cannot afford expenditure for KT and post-transplant care, can be supported by raising fund at national and international level. Conclusion: To increase living donor KT, techniques of increased graft survival, donor and recipient comfort, confidence and safety should be established . Inclusion of both brain death (BD) and Deceased Circulatory Death (DCD) in Deceased Donor pool will be good option for increasing donor pool. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.88-93

Objectives : To evaluate complications in Intra-prostatic local Anaesthesia and Periprostatic local Anaesthesia for TRUS Guided Prostate Biopsy. Methods: This study was carried out in the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College (DMCH) and Comfort Nursing Home, Dhaka during the period of January 2009 to October 2009, evaluate complications between periprostatic with intraprostatic local anaesthesia for transrectal prostate biopsy. For this purpose, a total number of 60 consecutive patients having increased prostate specific antigen (PSA >4.0ng/ml), abnormal DRE/transrectal ultrasound were admitted in the above mentioned hospitals were enrolled in this study for surgical management. Result : The age ranged from 50 to 90 years and the maximum number was found in the age group of 61-70 years in both groups. The mean(±SD) age was 68.5±7.5 years and 70.3±8.2 years in group I and group II respectively. No systemic lidocaine toxicity was observed in group II. But only dizziness were found in 2 cases (6.7%) and visual disturbance were found in 1 (3.3%) case respectively in group I. Urinary tract infection was found 2(6.7%) in group I and 1(3.3%) in group II patients. Hematuria was found 23(76.7%) in group I and 19(63.3%) in group II. Rectal bleeding was found 14(46.7%) in group I and 11(36.7%) in group II. The statistically not significant (p>0.05) between two groups in chi square and fisher exact test respectively. Conclusion : It is a simple and safe method that is less painful and it should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy. Complications wer4e less in intra-prostatic local anaesthesia than periprostatic local anaesthesia for TRUS guided prostate Biopsy. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.82-86

Objective: This study is designed to observe the short-term outcomes of dorsolateral onlay urethroplasty to treat long segment anterior urethral stricture. Materials and Methods: A prospective study from May 2011 to September 2012 is carried out in department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBanglanagar, Dhaka. Thirty one patients with long anterior urethral stricture were treated by a dorsolateral onlay buccal mucosa graft. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry

Objective: To assess the articles published on current treatments for Peyronie’s disease (PD) and it’s new development and to assist clinicians to select the effective management of PD by increasing understanding and awareness of the outcomes associated with current medical and surgical treatment options. Methods: A Hinari literature search was conducted to identify relevant, peer-reviewed, clinical and review articles published related to current treatment options and it’s new developments of Peyronie’s Disease. Search terms for this non-systematic review included ‘Peyronie’s disease’, ‘current treatment, outcomes’, new development. ‘Erectile dysfunction or ED’, search terms were searched separately and in combination. Case studies and editorials were excluded, primary manuscripts and reviews were included, and references of articles of interest were reviewed and key references were obtained. Result: Currently, there are several investigational minimally invasive and non-surgical treatment options for PD; however, surgical treatment remains the standard of care for patients with stable disease and disabling deformity or drug-resistant erectile dysfunction. Each of the different surgical procedures that are used for treatment of PD, including tunical shortening, tunical lengthening (plaque incisions or partial excision and grafting), and use of inflatable penile prostheses, carries its own advantages and disadvantages in terms of potential complications and postoperative satisfaction. No single, standard, surgical treatment for this disorder has prevailed and multiple variations of each type of procedure exist. Obtaining data on current treatment and its modifications to these procedures, and new surgical techniques and materials may serve to further guide Conclusion: The real etiology of Peyronie’s disease and the mechanisms of formation of the plaque still remain obscure. Although conservative management is obtaining a progressively larger consensus among the experts, surgical correction still remains the mainstay treatment for this condition. Treatment should be tailored to each patient after a detailed evaluation of disease severity and sexual function. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.87-96

Objective: To compare the outcomes of tubularized incised plate urethroplasty and modified tubularized incised plate urethroplasty in the primary management of distal hypospadias Materials and Methods: Total 70 patients of age group 2 to 10 years with distal hypospadias were selected for this study from January 2008 to December 2010. They were divided into Group-A (n=35) treated by the tubularized incised plate urethroplasty and Group-B (n=35) treated by the modified tubularized incised plate urethroplasty.The modification was performed by using inner preputial skin on the incised plate before tubularization. All patients were followed up immediately and at 4th, 8th and 12th weeks after operation. Results: The satisfactory cosmetic and functional outcomes were observed in 29 patients (82.85%) of Group-A and all families of Group-B were happy with aesthetic and functional outcomes. Urethrocutaneous fistula developed in 5 patients (14.70%) patients of Group- A and 1 (2.94%) patient in Group-B. Three patients (8.82%) in group-A and one patient (2.94%) in group-B were found to develop meatal stenosis. One patient (2.94%) developed stricture urethra in group A but no patient in group-B developed urethral stricture. Overall complications occurred in 10 patients (29.41%) in Group-A and 2 patients (5.88%) in Group-B. Conclusions: This study demonstrates that modified tubularized incised plate urethroplasty had excellent cosmetic and functional outcomes and fewer complications than that of tubularized incised plate urethroplasty in the primary management of distal hypospadias. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.75-81

Objective: To observe the improvement of the symptoms of pelvic pain, dysuria and haemospermia after treatment with magnetic infrared laser therapy in patients with chronic pelvic pain syndrome. Methods : This study was an observational study done on 30 male patients with pelvic pain and age range varied from 30 to 60 years. The study was conducted from 2009 to 2011 in a private medical center in Dhaka city . The MIL-therapy in use has a wave length of 904 nm and a frequency of 3000 Hz. The Laser beam reaches the prostate with a special optic probe. In this study the patients were examined per rectally by doing digital rectal examination with use of gloves and gel. At the beginning we used a “Laser Super Sonic” machine with endorectal probe according to Strada. The treatment schedule was one treatment every two days (treatment’s time of 5/10 minutes, wave length 1000 KHz)) for a total of 10 applications. After 10 applications patients were asked for follow-up and data were callected and analysed. Results : Out of 30 patients of chronic pelvic pain syndrome aged between 30-60 yrs with compains of pelvic pain, dysuria and haemospermia were under treatment with MIL therapy. 18 patients with pelvic pain, 13 patients with dysuria and 04 patients with haemospermia were cured after laser treatment . There were improvement of symptoms of pelvic pain in 11 patients, dysuria in 07 patients after laser therapy . But 01 patient found not improved . Among 30 cases 23 patients found normal sized prostate and 07 found enlarged prostate on digital rectal examination and on USG findings, 21 were found normal sized, 09 found enlarged sized prostate and 07 patients had increased PVR Conclusion : Patient sign and symptoms improved significantly after M/L therapy. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2014 p.42-46